Duke University, Duke Clinical Research Institute and Duke University Health System propose the PARTNER project (Prevention Approaches To UNdERage Alcohol Use) for capacity building in the primary care system to design, test and deliver interventions to address rural underage drinking. The target counties for PARTNER are the seven rural counties of Durham, Person, Vance, Granville, Franklin, Warren and Halifax in the piedmont region of North Carolina. PARTNER will serve a population of approximately 45,000 youth including 18,000 African-American youth. PARTNER will focus on building capacity within the Duke Affiliated Physicians (DUAP) a well-established network of Primary Care Practices in the target counties. Specific Aim 1 proposes infrastructure development and capacity building within the primary health care provider (PCP) network. The investigator team will work with a core of 7 PCP partners to establish a collaborative alliance to support intervention and prevention efforts. This alliance will link with PCPs with schools, social service agencies, faith based organizations, law enforcement, and substance abuse service providers, and importantly youth and parents. Specific Aim 2 proposes a longitudinal ecological epidemiology of underage drinking based on annual administration of the Youth Risk Behavior Survey (YRBS) in schools and to the estimated 2000 students enrolled in community colleges. Specific Aim 3 will be the preparation to implement interventional and prevention approaches. Two pilot studies will be undertaken. Specific Aim 3a will examine the feasibility of a brief intervention within the primary care setting. Specific Aim 3b will test an individual/ system level approach to maximize the number of underage youth, particularly African-Americans who can be accessed for intervention. The public health benefits of the project are three fold: First the project will broaden the role of primary health care networks in the intervention and prevention of rural underage drinking. Second it will establish a collaborative model of communication and cooperation among the community partners to develop and sustain efforts to address underage drinking, in particular among the rural African-American community. Finally it can indicate integrate evidence-based interventions for underage drinking into primary care practice.